World Cancer Day 4th February

KNOWING CANCER

Facts about Cancer

Cancer is a disease where abnormal cells divide without control and, most times, form a lump (called a tumour) as their numbers increase. Cancer cells can invade nearby tissues and can spread through the bloodstream and lymphatic systems to other parts of the body. Although great advances have been made in the treatment of cancer, cancer patients who are diagnosed relatively late has limited treatment options. Therefore, prevention and early detection of cancer are the key to control cancer. Some of the most common cancer types, such as breast cancer, cervical cancer, oral cancer and colorectal cancer have high cure rates when detected early and treated according to best practices.

Top 5 Common Cancers in Singapore

In Females

Breast

Colo-Rectum

Lung

Corpus Uteri

Ovary

In Males

Colo-Rectum

Lung

Prostate

Liver

Lymphoma

Colorectal Cancer

Currently the most common cancer in Singapore.

Affects the large intestine, made up of the colon and rectum. Also known as colon cancer, rectal cancer or bowel cancer.

Most persons diagnosed with colorectal cancer are older than 45 years of age. Younger persons, younger than 20 years of age, if diagnosed to have colorectal cancer, are likely to have the hereditary form of colorectal cancer such as familial adenomatous polyposis.

The risk of colorectal cancer is increased when there is: A personal history of previous colorectal polyps or colorectal cancer; A personal history of inflammatory bowel disease such as ulcerative colitis; A family history of colorectal cancer and/ or familial adenomatous polyposis or hereditary non-polyposis colorectal cancer.

Common symptoms are a change in bowel habits, such as persistent diarrhoea or constipation or a change in the frequency of stools. Passing blood mixed with stools is also a suspicious sign which always requires prompt medical attention. Other symptoms include persistent ill-defined abdominal discomfort or pain. Occasionally, a mass is felt in the abdomen.

The simplest way to detect a rectal cancer is by insertion of the doctor’s finger into the rectum, i.e. a rectal examination. This can be done in the outpatient clinic, takes less than 5 minutes and causes minimal discomfort. However, this detects cancers only in the last 5 to 8cm of the rectum.

For cancers that are more distantly located in the large intestine, sigmoidoscope or colonoscope examination can be performed. These fiber-optic flexible tubes are inserted up the rectum into the colon. Through these scopes, removal of a small piece of growth for testing is possible. Insertion of these scopes are performed with minimal anaesthesia in an outpatient clinic. Although uncomfortable, the procedure lasts less than 30 minutes.

Breast Cancer

Most common type of cancer among women in Singapore. 1 out of 17 women likely to be afflicted by breast cancer.

Occurs when breast cells become abnormal and divide without control or order. Usually starting in the milk ducts.

The risk of breast cancer increases with age. Most women who are diagnosed to have breast cancer are older than 40 years old, but younger women may also be affected. It also increases with the length of the fertile period, i.e. from the first period to menopause. A woman whose menopause occurs at 55 years of age has a significantly greater risk than a woman who menopauses at 45 years of age. Age at first completed pregnancy is also important: having the first completed pregnancy after the age of 30 years increases the risk compared to those who complete the first pregnancy before age 30. Likewise, women who have never been pregnant also have a higher risk of getting breast cancer. Breast feeding also protects against breast cancer. Hormone replacement therapy increases the risk of breast cancer and this should be discussed before embarking on the treatment.

Between 5 to 10% of all breast cancers are associated with genetic factors. The genes BRCA1 and BRCA2 have been identified and may be associated with breast cancer occurring in approximately half of all families with a very strong history of breast and/or ovarian cancer.

About 80% of women with breast cancer first consult their doctor with a symptom they notice themselves. The most common feature is a breast lump. The lump may or may not be painful. Sometimes the nipple may be puckered (indrawn) or bleeding, or there is swelling of the skin of the breast. There may be a discharge from the nipple. Lymph glands of the armpit may also be enlarged. In advanced cases, breast cancer can spread to the liver, lung, bone, or brain.

Diagnostic test: A mammogram is an x-ray examination which helps to define the extent of the lump. It is sometimes combined with an ultrasound of the breast to determine if the lump is mainly solid or cystic, i.e. filled with liquid only. Mammograms are much more useful for screening than for evaluation of symptomatic masses. Even if the mammogram is completely normal, a symptomatic breast mass may still need to be biopsied

Prostate Cancer

The 3rd most common cancer affecting men in Singapore.

Prostate cancer develops when the cells in the prostate gland (located below the bladder) grow too rapidly, forming a malignant or cancerous lump.

Most prostate cancers grow slower than other cancers. Advanced prostate cancer can spread to the lymph node and bones.

Prostate cancer is mostly a very slow progressing disease. In fact, many men die of old age, without ever knowing they had prostate cancer.

There is no single cause of prostate cancer. It is thought that smoking and family history are among the contributory factors.

Early prostate cancer is usually without symptoms and may be picked up incidentally during a routine examination of the rectum. With more advanced disease there may be difficulty passing urine. The cancer can spread to any organ or tissue in the body with the most common site of spread being the bone. As such a common symptom is bone pain.

Diagnostic test: Rectal examination whereby the prostate gland is examined with a gloved finger in the rectum by a doctor. Apart from physical examination, blood tests (Prostate specific antigen or PSA) help to diagnose prostate cancer.

Screening can help detect cancer in its early stages for effective treatment. Coming forward for an early detection and treatment can improve chances of cure. Contact your doctor or Lifescan Medical Centre for your next health screening appointment.

Incorporated in 2005, Singapore Medical Group (SMG) is a private specialist and primary healthcare provider with a network of more than 20 medical specialties. The Group is committed to its promise of providing patient centred medical care and experience to every individual.
SMG has more than 27 clinics and a growing network of SMG Associates clinics all across the island.